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FORM 1045-A
REV. 1116-35
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
DOM,
D
JUN 27 1936
R
5
SEP 2 1936
5
10
Dear Madam:
0
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all enrolled Red Cross Nurses with their latest addresses. We are
extremely anxious to make a very complete report and ask for your cooperation. Will
you kindly answer the following questions and return this form to me, in the enclosed
envelope, at the earliest possible date?
Yours sincerely,
IMPORTANT:
In order to render prompt service
in time of disaster, enrolled Red Cross
Ida 7. Butter
Nurses should report at once to the
Secretary of the Local Committee under
Acting National Director,
which they are enrolled. Do not forget
the address of the Secretary.
Brana.
Red Cross Nursing Service
Name in full o'malley Our Louise
-
If married, give husband's name
Permanent address 746 ETC.) SanTrancisco (CITY) (COUNTY)
(STREAT
Geary
California
(TATE)
Probable address for the next year
Same
(STREET, ETC.)
Telephone No Prospect 5016
San Trancis co
California
(CITY)
(COUNTY)
(STATE)
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Underline the type of work you are now doing:
AliceD.Malley
above address
Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service
-
Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been? no
Indicate present physical condition good
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Pin is not available.
herping
Badge No. member of the
1st Palestine Unit
Current date Sept.21-36
NOTE. -- If the nurse does not complete and return this questionnaire, and can not be
This Questionaine Romanded from normal Hall. manila. P.A.
located within two years, her enrolment will be removed from our active files
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"ocrText": "0\nM\na\nFORM 1045-A\nREV. 1116-35\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nDOM,\nD\nJUN 27 1936\nR\n5\nSEP 2 1936\n5\n10\nDear Madam:\n0\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all enrolled Red Cross Nurses with their latest addresses. We are\nextremely anxious to make a very complete report and ask for your cooperation. Will\nyou kindly answer the following questions and return this form to me, in the enclosed\nenvelope, at the earliest possible date?\nYours sincerely,\nIMPORTANT:\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nIda 7. Butter\nNurses should report at once to the\nSecretary of the Local Committee under\nActing National Director,\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nBrana.\nRed Cross Nursing Service\nName in full o'malley Our Louise\n-\nIf married, give husband's name\nPermanent address 746 ETC.) SanTrancisco (CITY) (COUNTY)\n(STREAT\nGeary\nCalifornia\n(TATE)\nProbable address for the next year\nSame\n(STREET, ETC.)\nTelephone No Prospect 5016\nSan Trancis co\nCalifornia\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline the type of work you are now doing:\nAliceD.Malley\nabove address\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service\n-\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? no\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nPin is not available.\nherping\nBadge No. member of the\n1st Palestine Unit\nCurrent date Sept.21-36\nNOTE. -- If the nurse does not complete and return this questionnaire, and can not be\nThis Questionaine Romanded from normal Hall. manila. P.A.\nlocated within two years, her enrolment will be removed from our active files"
}